Treating a sick human being as a whole person is an old concept even in western medicine in the olden days, even as recently as the 1950s when I was a student. Thanks to the hi-tech new western medicine of complete reductionism, whole person healing (WPH) has almost disappeared from a medical student’s vocabulary! As human beings, we have our bodies, which are but the illusion of our mind, our worries and anxieties, our social and environmental factors, our economic and social status, and above all, our religious beliefs which could collectively and severally affect our personality as a patient. The best doctor to know all these would be our family doctor. Again thanks to the birth of sub-specialties, which in India are called super specialties making them God incarnates, the old concept has taken a back seat as the sub-specialists do not understand that.
The last class knows more and more about less and less. This tendency to diagnose and treat patients with a tinted glass of reductionism has become the bane of western medicine today. In more advanced set ups, the patient is hardly listened to or examined physically. The symptoms direct the huge list of investigations and from then on, the specialist treats only the reports and NOT the poor sick human being resulting in much misery and economic loss to the patient and gain to the medical and pharmaceutical establishments. It is usually outsiders who spot these lacunae in any system and think outside the box. Both Albert Einstein and David Bohm declared themselves outsiders for physics and so were able to think outside the box.
My good friend, a great scientist, who could think out of the box even in his own specialty of chemistry and metallurgy, was appointed Professor of Medicine at the University of Arizona — though he had no conventional medical qualifications — based on his original research in human healing. It was he who coined the term whole person healing (WPH). While I used to write and think about it as bedside medicine, Prof Roy picked me up in one meeting where both of us were lecturing and convinced me to join him in this journey of WPH. Thus started our long journey to end only when he died. The late professor was a remarkable man and one of the best scientists I had known all my life. He was the first to think of nano particles way back in 1954 when he was a junior member of Linus Pauling’s chemistry department at Berkeley University. His original paper on Sol-Gel technique is still being used by nano scientists. The paper had more than 75,000 citations till date! Although he was the Fellow of all Science Academies of the World with a Golden Ray award from the Emperor of Japan, he was denied the Nobel Prize despite being nominated 21 times! I think it was because of his pro-Indian bias and his original works did not interest the industry so much. Being the founder-fellow of the IOM (Institute of Medicine) he was able to get the word WPH officially added to the medical vocabulary in 2009.
Since then I have adopted that word in place of my bedside medicine which is patient-centric, not disease-centric. We started the World Academy of Authentic Healing Sciences in 2005 with our own journal, The Journal of the Science of Healing Outcomes (thejsho.com) of which I became the editor-in-chief and Professor Roy the co-editor-in-chief till his death. He was followed by Hans Peter Duerr, the Emeritus Director of the Max Planck Institute in Munich. Now we have Evan Pugh, Professor of Obstetrics and Paediatrics at Penn State University and Yana Floros as the co-editor-in-chief. She is a great researcher too.
I happened to see a very fit young man last week. He was 46 and a specimen of physical fitness in every respect. The only mistake I think he used to make was jog daily, nearly 5 km. One day, while jogging he thought he had vague chest pain. He went for a check-up. To cut the long story short, he landed on the angioplasty table to have two stents and life-time blood thinners with some medicines. He was devastated. His family and he are now worried stiff and he was even contemplating becoming a recluse! Our reductionist intervention has had such an impact on his whole family that I am sure he will not be a useful citizen for the country. Coronary artery blocks are not coronary artery disease. Even young boys in the US army in Korea and Vietnam, with an average age of 20 years, angiogrammed postmortem after they were shot dead (a total of 205 soldiers ) had three vessel blocks (72 per cent). Some had even left main equivalent blocks but they were in the pink of health to be in the US army. Reductionist science equated coronary block with coronary disease, a good business proposition.
I have a very dear friend who in his 80s had bad knee joints but was still active. I used to discourage him to have joint replacement. He also had aches and pains everywhere. Our friends convinced him to have it done and one of his knees was operated upon. He never recovered fully from his post-operative sickness and had pneumonia first, thanks to nosocomial infections, and as he was getting out of those episodes, his aches and pains increased. After investigations they came up with a diagnosis of multiple myeloma now. I wonder if the diagnosis was missed pre-operatively or was it that multiple myeloma was triggered by the surgery? God only knows. He is in bed and is suffering. What is the quality of life we have been able to offer him? When is the whole man considered our primary interest? Where are we headed? Professor Mary Tinnetti of Yale University in her article in the American Medical Journal entitled, The end the Disease Era, convincingly argues to show that the organ-based disease diagnosis has almost come to an end and she wants that replaced with a new holistic approach. Sick human being needs our compassionate understanding and a useful management, not heroic things done to set the anatomy right.
Western medicine is not true science. It is just a statistical science where averages of all measurements are converted into normals. When one converts averages into normals, one generates 5 to 25 per cent false positives. Today, the diagnosis has become a disease in itself. We can create epidemics where none existed and we convert the hapless human beings who come to us with their anxiety for help into patients for the rest of their lives! Let us try to reintroduce WPH into the medical curriculum for the common good of mankind.
Prof B M Hegde is a cardiologist & former vice-chancellor of Manipal University
Email: hegdebm@gmail.com